Moss, Mark

Moss, Mark is an individual health care provider with primary practice located at 720 Harrison Ave Suite 707, Boston MA 02118-2371. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Moss, Mark can be contacted via phone (617) 638-8456.

Contact Information

Primary practice address
720 Harrison Ave Suite 707 Boston MA 02118-2371
Phone: (617) 638-8456
Fax: (617) 638-8465
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 3324 Massachusetts

Profile Details

NPI number 1174586382
LBN Legal business name Moss, Mark
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Aug 14th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174586382 NPPES
Massachusetts MEDICAID 0516554

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